Impact of Pial Collaterals on Infarct Growth Rate in Experimental Acute Ischemic Stroke

Area of Science:

• Neurology
• Radiology
• Biomedical Engineering

Background:

• Cerebral infarction progression varies with blood flow, impacting treatment timing.
• Pial collateral recruitment influences the rate of infarct evolution.

Purpose of the Study:

• To mathematically model infarct growth in a canine MCA occlusion model.
• To determine if angiographic assessment of pial collaterals predicts infarct volume growth.

Main Methods:

• Quantified pial collateral recruitment using DSA and arterial arrival time.
• Measured infarct volumes via MRI at multiple time points post-MCA occlusion.
• Correlated collateral assessments with infarct growth rate and final volume using linear analysis.

Main Results:

• Pial collateral assessment strongly correlated with 24-hour infarct volumes (r=0.96 for score, r^2=0.86 for arrival time).
• Infarct growth rate showed significant linear relationships with collateral score (r=0.89) and arrival time (r=0.69).
• Predictive models for infarct growth based on collateral assessments were developed and compared.

Conclusions:

• Pial collateral assessment in MCA occlusion models correlates with infarct growth rate.
• Angiographic collateral assessment has potential for predicting asymptotic infarct volume growth.
• Predictive models showed no statistical advantage of collateral score over arrival time, despite lower errors.